Advances in Supportive Therapy for Patients With Thalassemia: A Systematic Review

ObjectiveTo analyze various innovative approaches in the supportive therapy of patients with thalassemia and to summarize the efficacy of different biomedical interventions from Randomized Controlled Trials (RCT).MethodsThis systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and registered in PROSPERO (CRD420251163054). A comprehensive literature search was conducted across four major databases: Scopus, PubMed, ScienceDirect, and Sage Journals. The inclusion criteria for this review involve patients with thalassemia, focus on the supportive therapy of thalassemia, conducted in healthcare settings, and employ a RCT design. The literature quality was evaluated using the Joanna Briggs Institute (JBI) tool for RCT. The data were synthesized using a narrative synthesis approach.ResultsFrom 2,394 records, 13 articles were identified. Luspatercept and Thalidomide were found to be the most effective in reducing transfusion dependence and increasing hemoglobin levels. For iron overload, Amlodipine and Spirulina significantly improved cardiac T2*, contributing to cardioprotection. Furthermore, Curcumin supplementation was shown to improve lipid metabolism and inhibit systemic inflammation. Meanwhile, therapies using Green Tea and Vitamin E were effective in reducing markers of cellular oxidative damage, with Green Tea also demonstrating dual efficacy in reducing serum ferritin (SF) and liver iron concentration (LIC).ConclusionOverall, new and adjuvant supportive therapies significantly support the biological management of patients with thalassemia. Further studies are required to integration between pharmacological therapies and nutraceutical approaches should be further explored to optimize improvements in hematological status, oxidative stress, and patients' metabolic profiles.